What are "stuck points"?
In 1992, researchers Resick and Schnicke first described the term "stuck points" in their work exploring PTSD. Stuck points refer to thoughts that repeatedly bubble up in a person's inner (and outer) dialogue that make it difficult for a person to process, cope with, or reconcile their experiences.
To me, stuck points are like mean old trolls living under a bridge. Whenever a person tries to gain some momentum in working through their experiences, the troll comes up and says "Nope, you can't pass. Now go back and think about what's happened."
Stuck points aren't emotions, rather they're thoughts that result in distressing emotion. For example, a person might have the thought, “I should have done more to save my loved one” and as a result, they feel guilt.
Many grieving people struggle with memories and/or thoughts that have distressing emotional consequences, but when everything is so intertwined it's common to interpret distressing thoughts and emotions as one and the same. This can complicate matters because (1) it can create a downward spiral of negative thoughts and emotions and (2) some people get so distracted by their emotions that they fail to address the underlying thought.
Resick and Schnicke specifically assert that stuck points may negatively impact sense of safety, trust, power, esteem, and intimacy. Especially, when these beliefs are fixed and rigid (i.e. inflexible). If you have a few minutes, check out the following video on the connection between thoughts, emotions, behaviors and stuck points.
Tell me more about how they arise:
There are two ways Cognitive Processing Therapists believe stuck points arise:
The loss or trauma experience contradicts a previously held belief. Afterward, the person struggles to reconcile this dichotomy.
Example: A person experiences the death of a loved one due to violence. Before the death, the person believed the world was a safe and just place, but this event has violated that belief. Now the person may worry they'll never feel safe again. They become anxious, hopeless, fearful, and unsure of how to live their life given their new reality.
The loss event reinforces previously held negative beliefs and the person becomes further stuck within this negative belief.
Example: A person has little confidence they can handle stressful situations and emotions. After experiencing the death of a loved one, their fear of distressing grief-related thoughts and feelings exacerbates this belief and they experience increased anxiety and a low sense of self-worth. These feelings keep them from doing things that could help them cope with grief or find support, which continuously reinforces the thought that they can't handle their grief.
How do I cope with stuck points?
Working through individual stuck points takes patience, perseverance, the courage to examine one's thoughts and emotions, and the cognitive flexibility to change them. Stuck points are unique to the individual and their experiences, so we encourage you to spend some time reflecting on any stuck points possibly impacting you in your grief and coping.
Also, try and notice the relationship between your thoughts and emotions. A simple way to do this is to find a piece of paper and divide it down the middle. On the top of the left-hand side write "When I have the thought that..." and on the top of the right-hand side write "I feel...". Then reflect back on the last week or so and try to identify some of the thoughts you've been having and their emotional consequences. If it's easier for you, you can also start by identifying the feelings you've been having and then trace them back to the thoughts or situations that preceded them.
At the very least, you're likely to identify some of the thoughts and emotions that have been most challenging to you in your grief. Perhaps these are areas where you will want to focus your coping - whether it's through reading articles like this one, journaling, support groups, or one-on-one counseling. Here on WYG, we've written about many different emotions and experiences, so we may have a resource to get you started.
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